Coronary Artery Bypass Surgery Provides Long-Term Results Superior to Percutaneous Coronary Intervention

Comparison of Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting

“…PCI and CABG are considered revascularization procedures, but only CABG has been proven to provide longterm prognostic benefits in patients with CAD [2,8]. Myocardial infarcts are usually generated by non-flowlimiting stenosis.…”

“…Rosenfeldt et al in their study analyzed recent evidence to conclude that CABG is more beneficial than PCI in patients with complex atherosclerotic lesions, multivessel disease, left middle circumflex artery (LMCA) disease, LVD, and DM. However, patients still usually prefer PCI because the procedure is minimally invasive [2]. In a systemic review that included 13 RCTs and five meta-analyses to demonstrate the effectiveness of PCI and CABG, Deb et al concluded that CABG should be recommended in patients with DM, LMCA disease, multivessel CAD, or LVD, and SYNTAX score >22 (severe CAD) due to improved long-term survival and lower cardiac events, whereas PCI is considered in patients with less complex CAD (SYNTAX ≤ 22) or if the patient is at a high surgical risk [10].…”

“…However, accumulating evidence shows that patients with complex atherosclerotic lesions, multivessel disease, left main stem disease, left ventricular dysfunction (LVD), and diabetes mellitus (DM) derive more benefit from CABG than from PCI. Therefore, CABG should be presented to these patients as the more effective intervention in terms of survival, freedom from re-intervention, and cost-effectiveness [2]. However, patients prefer not to undergo surgery because of a fear of complications and of physical and mental debilitation because of surgery [3].…”

What would surgeons like from materials scientists?

“…The most well known use of stenting is in the coronary arteries. While coronary artery bypass surgery is extremely successful and remains the gold standard for long term control of stable coronary artery disease, percutaneous coronary intervention (PCI) is a frequently performed procedure and is highly effective in the treatment of acute coronary syndromes . The technique involves introducing a collapsed balloon into the narrowed artery by means of a long percutaneous catheter.…”

The Effects of Preoperative Renin-Angiotensin System Inhibitors on Outcomes in Patients Undergoing Cardiac Surgery

“…1 Patients undergoing cardiac surgery are still at significantly higher risk for postoperative major adverse events. There has been great progress in surgical techniques and perioperative care over the past decades.…”